Individual
DR. LESLIE E WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 E COLUMBIA AVE, COLVILLE, WA 99114-3354
(509) 684-3701
(509) 684-5817
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 944-9644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00025469
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50517
L & I
—
05
—
8303893
—
WA
01
—
8924162
L & I CRIME VICTIMS
—
Enumeration date
10/12/2005
Last updated
04/28/2021
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